(Appeared in The Star-Ledger on May 8, 2013)
By Susan K. Livio and Dan Goldberg/The Star-Ledger
TRENTON — Gov. Chris Christie didn’t have to miss a day of work.
He entered NYU Hospital in New York on a Saturday morning at 7 a.m. for a 40-minute Lap-Band procedure, and said he was back home in Mendham by 5 p.m.
That’s just one of the advantages Lap-Band surgery offers compared to other types of weight-loss procedures — which can be more effective, but also carry greater risk and require more rest and recovery.
Gastric lap bands are appealing because they can be removed and do not alter a patient’s anatomy, explained David Ward, a gastric surgeon at Morristown Medical Center. In the procedure, an adjustable band is laparoscopically placed through a small incision around the top of the stomach to create a smaller pouch, restricting the amount one can eat. The band can be tightened or loosened depending on how the weight loss is progressing.
“The lap band is just a restriction procedure that just pinches the stomach — like an hour-glass,” Ward said.
Other surgical options are far more invasive. Gastric bypass surgery, for example, involves surgeons creating a small pouch by stapling off a portion of the stomach, said Angela Glasnapp, a general and bariatric surgeon at Somerset Medical Center. Surgeons then reroute the small intestine in order to create a bypass before the food begins to be absorbed by the body. Most patients stay two nights in the hospital.
In an interview with ABC News last July, Christie said he has never considered gastric bypass surgery because it’s “too risky.”
A gastric sleeve involves the cutting away of about three-quarters of the stomach, and also requires one overnight stay in the hospital as opposed to hours, Glasnapp said.
These other options can be more effective because they cause hormonal changes that decrease hunger where as the band is just limiting the amount the stomach can hold.
Christie said his doctors advised him that Lap-Band surgery would be most effective for him, but would not discuss specifics of the advice.
One of the factors doctors consider, said Michael Bilof, chairman of the Bariatric Surgery Center at St. Barnabas Medical Center in Livingston, is how much weight a patient needs to lose.
“If someone needs to lose 150 to 200 pounds, the band is less effective,” Bilof said.
Christie would not comment on how much weight he’d like to lose, but patients who have Lap-Band surgery can expect to lose 50 percent of their excess weight in 18 months, Bilof said.
Dorothy Judith Johnson, of Plainfield, who went through the same procedure as the governor, shed 125 pounds from her 5-foot-2 1/2-inch frame. The 70-year-old social worker and therapist credits the surgery and the encouragement of her doctor and support group with creating an amazing physical and emotional transformation that she couldn’t imagine seven years ago when she needed a wheelchair and a walker.
The band reminds her stomach not to overdo it. “My stomach is saying, ‘I am not allowing you to do this anymore,” she said.
Christie said his appetite has been reduced since surgery and he is not as hungry as once was, but the surgery, as the governor pointed out during the press conference, is only the beginning.
Post-surgery, patients are instructed to eat slow and chew well, and pay attention to the “sense of fullness” that will happen more quickly, Ward said.
“You have to really be disciplined and eat right,” he said.
The surgery will only take the patient half of the way to their desired weight. “If you don’t do the other 50 percent you are not going to be successful,” he said.
Judy Torres, of Jersey City, learned that the hard way. After shedding 66 pounds, she put 50 back on when she stopped following doctor’s orders and returned to her old eating habits.
“I had the fluid taken out (of the band) and I went back to my old ways,” she said. “All these procedures are tools. If you don’t change what you are doing you can’t expect a miracle.”
Jaime Pula, registered dietician and exercise physiologist, said it is crucial for patients to alter their diet if they expect to see results. “This is altering the original equipment,” she said, “so you can’t physically hold a high volume of food.”
Pula said patients start on a liquid diet and slowly return to solids but there are certain foods that are never recommended like carbonated soda and alcohol. Patients, she said, also should avoid eating and drinking at the same meal all in an effort to avoid filling the smaller stomach too quickly. That can lead to constipation, cramps and vomiting.
“If it’s not going down, it’s coming back up,” Bilof said.